Quality Control A process employed to ensure a certain level of quality in a service. DialysisK-DOQI

Quality control WhoMedical service suppliersPersonnel Medical DevicesHowPractice = dialysisWhomTo the patients

Services and Patients ExpectationsHospitalPatient receive the correct treatments?Patient treated courteously by all personnel?Hospital environment support patient recovery?

1859

Quality managementSystematic policies, methods, and procedures used to ensure that medical services are produced with appropriate levels of quality to meet the needs of patients.

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KPI Key Performance Indicator KPI

KPI

KPI2.4 2.4.21Kt/V1.2 Kt/V1.7

3.5g/dL

Hct 26%

55 10%

RCA (Proximate cause)

(Root cause)

80/20 (vital few) (trivial many)

PDCAPlan:Do:Check:Assessment:

assessment

PDCA Plan Do Check Assessment

2.4 2.4.21AB

Albumin:

KT/V: Kt/V

KPIKT/VAlbumin: Survival: : : : ??? KPI?

KPI?Albumin? KT/V?Albumin > 3.7?KT/V > 1.4?Albumin < 3.5< 3%?KT/V < 1.2

???

KT/VAlbuminHbnPCRInfection rateVascular thrombosisPeritonitis rateHospitalization rateMortality rateWhat value?How?

4017391720001.20.85?

GuidelineGuidelines are fundamentally designed to bolt on quality from the top down, .Guidelines are designed to automate medical practice. Practice guideline do not significantly improve care and may be harmful to our profession and our patients. Richard Amerling PDI 2005;25:140

FDA Box Warning June, 2011

SWOTStrength DMWeaknessCKD

OpportunitiesCKDPre-ESRDThreats

:CKDKPIPDCA